Health Plans
What type of health insurance plan can we purchase ourselves?
Individual Health Plan
What are the medical codes that represent a patients diagnosis?
ICD-10-CM
Which act set national standards for securing and protecting patients health information?
HIPAA Act of 1996
Which type of health insurance claim does a primary care provider use to submit for medical services?
CMS-1500 Claim and/or HCFA Claim form
What type of rate are providers and/or healthcare facilities paid for their medical services?
Contracted Rate
These type of health insurance plans are purchased by employers?
Group Health Insurance Plan
AMA maintains these medical codes?
CPT
Which acts require operating rules for transactions?
The Patient Protection and Affordable Care Act
We submit inpatient hospital procedures on what type of claim form?
UB04 and/or CMS-1450 Claim Form
How often are rates updated?
Annually
If you change jobs under a Group Health Insurance Plan what option do you have for temporary insurance coverage?
Cobra Insurance
Codes that represent inpatient hospital procedures?
ICD-10-PCS
What does ASCA stand for?
The Administrative Simplification Compliance Act
How many blocks does the CMS-1500 Claim form have?
33
Insurance Allowance- $95
Insurance Paid- $75
What is the patient responsible for and what does the provider need to adjust off?
Patient Responsible for- $20
Provider Adjustment- $105
Veterans Health Administration is an example of?
Government Sponsored Health Plan
Durable medical equipment is coded using what types of medical codes?
HCPCS
The ASCA requires all claims to be sent to which insurance?
Medicare
How many fields does the UB-04 claim form contain?
81
If we had incorrect information on a claim and it denied, what should we send to the insurance?
Corrected Claim
This type of health insurance plan may be eligible for a grant in premium payment assistance?
Individual Health Insurance Plan
ICD-10-CM codes are updated?
A. Quarterly
B. Annually
C. Monthly
B. Annually
What type of identifier is required on medical claims by Patient Protection and ACA?
What does HCFA stand for?
Healthcare Financing Administration
We filed the claim to late is an example of a?
Claim Denial